Health care analysis : HCA : journal of health philosophy and policy
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A considerable section of the population in India accesses the services of individual private medical practitioners (PMPs) for primary level care. In rural areas, these providers include MBBS doctors, practitioners of alternative systems of medicine, herbalists, indigenous and folk practitioners, compounders and others. This paper describes the profile, knowledge and some practices of the rural doctor in India and then discusses the reasons for lack of equity in health care access in rural areas and possible solutions to the problem.
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This paper addresses the issue of how the scientific discourse of genetics is expressed in local idioms. The examples used are taken from fieldwork conducted in Sri Lanka and relate principally to Sinhala Buddhist attempts to socialise 'big science.' The paper explores idioms of both nature and nurture in local imagery and narratives and draws attention to the rhetorical dimensions of genetic discourses when used in context. The article concludes with a preliminary attempt to identify the ways in which explanations of genetic causality are aligned with notions of karma in the explanation of illness and misfortune.
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In this paper I argue that resource allocation in publicly funded medical systems cannot be done using a purely substantive theory of justice, but must also involve procedural justice. I argue further that procedural justice requires institutions and that these must be "local" in a specific sense which I define. ⋯ However, I resist the identification of this normative account of local justice with the actual approach to local decision-making taken within the UK National Health Service. I illustrate my argument with reference to the case of provision of In Vitro Fertilisation within the UK NHS.
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Ethics guidance and ethical frameworks are becoming more explicit and prevalent in health policy proposals. However, little attention has been given to evaluating their roles and impacts in the policy arena. Before this can be investigated, fundamental questions must be asked about the nature of ethics in relation to policy, and about the nexus of the fields of applied ethical analysis and health policy analysis. ⋯ Second, we must understand better how explicit attention to ethical concerns affects policy dynamics. Third, we require new policy and ethical analytic approaches that contribute to constructive (not obstructive) policy making. Finally, we need indicators of robust, high quality ethical analysis for the purpose public policy making.